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And by "visitor", I'm hoping you're either a Speech–Language Pathologist, SLP student, or SLP Scientist... otherwise, this content is going to confuse the heck out of you!

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In order to implement evidence-based practice, you must know what the research shows! That’s where we come in. Our reviews inform you about the latest, most clinically-relevant research, and discuss how it can be applied directly to practice.

Our Evidence You Can Use reviews are divided into two sections:

Early Intervention (birth–3)

Preschool & School-Age (ages 3–21)

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Our team works hard each month to help keep you up-to-date on our field’s research. For more info on how we write the reviews, see FAQs.

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First, you can read, print, or listen to our content, each month when it's published:

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And once you find what you're looking for, the reviews look like this:

Cultural proficiency 101: Reconsidering the 30 million word gap

Back in the 1980s, Hart & Risley conducted a hallmark study documenting that children from poor communities hear 30 million fewer words than middle class children. This finding has been often cited to document why so many low SES children perform poorly when they enter school and score lower on measures of language and vocabulary.

Sperry et al. brought the results of this study into question, with the idea that the original methodology of the study may have been culturally biased and not applicable to real-life environments. In particular, the original study looked only at directed speech from the primary caregiver (usually the mother) to the child. They did not measure the number of words spoken by other members of the household, speech that the child may have overheard, and they encouraged the family members not to talk to each other so that they could focus on just the mother/child interaction.

While interaction between the primary caregiver is certainly important, Sperry et al. attempted to expand our knowledge of children’s verbal environments by measuring all speech directed to the child and all bystander or “overheard” speech. The findings were quite interesting. There was no significant gap between number of words heard among any social or economic class. Additionally, some working class and poor communities showed an advantage in the number of words the children heard. Additionally, there was significant variation within classes, rather than between classes. For instance, in this study, poor African American families in the south addressed far more words to their children compared to primary caregivers from other low SES communities (e.g. rural, working class).

These results are important to consider as EI therapists working with diverse families. Often times minority families are viewed in a “one size fits all” context, viewing the majority group (middle class American families) as the model. In fact, in many cultures, children are not spoken to directly during the first few years of life, but still reach developmental language milestones similarly to American children. In sum, different cultures have different preferred ways of interacting with their children, which may all have different benefits. As culturally proficient therapists, we need to look at the whole family.

P.S. This article sparked a bit of a debate:

For a response to this article from another group of researchers, click here.

Does the order of your therapy activities matter?

You see a kindergartener with developmental language disorder (DLD) for language therapy. You pick some toys, a game, or a book that will elicit lots of examples of the grammar targets you’re working on. While you play, you give her plenty of models, and use recasts to help her correct her own productions. Sounds pretty typical, yes?

This article has a tip to make that intervention even better: if you’re doing auditory bombardment as part of language therapy, do it at the end of your sessions.

So often we read research studies and think, “That sounds great, but how would I EVER implement it in my real practice?” Here, we have a small study examining a specific, practical question on how to make the therapy we’re doing more effective. YAY. More of this, please!

In the study, a group of 4–6-year-olds with DLD got a half hour of enhanced* conversational recast treatment for targeted morphemes, of which the first or last 2–4 minutes were devoted to an auditory bombardment activity—something like having the child turn over picture cards while the clinician said phrases with the target structure. Overall, the therapy was effective, and the children improved in their use of the focus morpheme compared to controls. But—the researchers found that more children benefited from the therapy when auditory bombardment came last. Why? The authors suggest that it helped “consolidate the child’s internal representation” of the morpheme. Doing the bombardment first didn’t seem to offer any advantage over not doing it at all, based on a comparison with equivalent treatment groups from the authors’ previous work.

*Recasting, where the clinician repeats the child’s utterance, correcting any errors of grammar, is an evidence-based language intervention strategy. The “enhanced” part means that clinicians got the children’s attention before doing the recast, and also that they made sure to use different verbs each time. We know children learn better from a wider variety of examples. Check out the paper for more details on how the actual therapy worked!

“Ouch!”—Selecting pain vocabulary for kids who use AAC

A couple years back, we reviewed this study that developed a list of pain vocabulary for kids who use AAC. Quick refresher on their rationale—all kids have and need to express pain, but for kids who use AAC, this can be challenging since we often don’t know what they want to say when in pain. So the authors asked children, parents, teachers, and adult AAC users how they would respond in painful situations, and compiled a response list. Makes sense, right? This list should be widely used! Well, not so fast. There were some caveats, including that the list was drawn only from participants in South Africa.

Well for those of you not in South Africa, do I have good news for you! The same authors took that vocabulary list, and combined it with 16 other studies of children’s pain expressions. The studies included direct quotes from 2,683 children who spoke six different languages, and came from eight different countries. They took the pain words and phrases, divided them into descriptive themes and categories (e.g., indicates location of pain, or requests treatment), broke them down into single words, and separated these words into core (“you”), pain-related fringe (“medicine”), and other fringe (“movie”).

The end-result? The review lists 60 pain-related words that children use most often to talk about their pain (see paper Appendix), as well as some useful categories of words that we might not initially consider when selecting vocabulary (e.g., “employing fake bravery”).

So, now can we feel confident using this list with kids on our caseload? I’d say so, but of course with some awareness of its limitations. It is a great starting point, but as the authors point out—when selecting vocabulary for each individual child, we must consider his/her individual context/needs. Also, the review only included typically-developing children, so we can’t ignore that we may be missing out on some vocabulary unique to kids with disabilities, and specifically those who use AAC.

Kids tend to be most accurate with past tense -ed on verbs that they hear in the past tense a lot, that are easy to say, and that make a lot of sense in the past tense—words like played and jumped. Seems pretty obvious, yeah? We are good at stuff that is easy. And when your goal is early success for your clients, you follow a developmental model and pick the easiest targets to start with. But there’s another, less intuitive, school of thought that says: Hey, life is full of the easy verbs. To really learn how to mark tense, kids need to get the hard verbs too. Let therapy be the place where they hear the hard ones. (Think of the complexity approach for phonology; see here for a recent tutorial).

So here’s the gist of it—you want to concentrate on verbs that are more complicated in their past-tense-edness, in terms of:

Frequency: Kids hear them in the past tense less often;

Phonology: They take the more complex form of the past tense morpheme (–ɪd vs. –t/–d, as in “glided” vs. “hopped”); and/or

Semantics: They describe an action that’s ongoing or incomplete*

The authors tested this approach with 20 children (4–10 years old) with DLD and poor performance on regular past-tense probes. The children whose therapy targeted “hard” verbs first (all verbs came from the set analyzed in this paper) were more accurate with regular past tense in both structured probes (right after intervention) and in language samples (post-intervention and 6–8 weeks later).

How could this look in real life? You could take your go-to therapy tools (play sets, favorite books, etc.) and brainstorm some target words ahead of time to help you get started. Jot them down on a post-it and keep it right in the box. Always pulling out that farm set? Maybe the cow rested in the barn while the pigs wiggled in the mud.

*This part is the trickiest to wrap your brain around. It’s helpful to make a contrast with the kind of verbs we don’t want, the ones that have a clear endpoint implied. For example, “build.” Once you’ve built something, it’s done, you can’t keep doing it. Same with “eat” or “drop.” The linguistic term for this is telic (so verbs that are “endless,” like “breathe” and “feel” are atelic). That’s Greek, y’all. Again, you can refer to the source for this study’s word lists here for more examples.

Like what you see so far?

That was just four reviews. As a member, you get 5–10 reviews per issue (or month). And recall that you can read them online, print them, or listen to our audio versions!

With access to the Evidence You Can Use reviews, you can stay up-to-date with research relevant to your practice with far less time per month than searching the evidence on your own. And unlike other research resources, we work for clinicians. Our team of PhDs and SLPs are committed to translating research in a way that’s easy-to-read, efficient, and usable. We're not here to give you "fun facts". We're here to make your clinical practice better. So you aren't just hoping you’re implementing evidence-based practice, but can feel confident knowing it.